Segregation of a Latent High Adiposity Phenotype in Families with a History of Type 2 Diabetes Mellitus Implicates Rare Obesity-Susceptibility Genetic Variants with Large Effects in Diabetes-Related Obesity

Objective We aimed to investigate whether patients with polycystic ovary syndrome (PCOS) and a family history (FH) of type 2 diabetes mellitus (T2DM) are at increased risk of endocrinological and metabolic abnormalities, and whether this risk differs between first-degree and second-degree relatives, and between maternal and paternal transmission. Methods A total of 680 patients with PCOS were enrolled in this retrospective, single-center study. Endocrine and glycolipid metabolism parameters were compared. Results The free androgen index (FAI), and levels of fasting blood glucose (FBG), fasting insulin (FINS), homeostatic model assessment-insulin resistance (HOMA-IR), total cholesterol (TC), and low-density lipoprotein cholesterol were significantly higher, whereas sex hormone binding globulin (SHBG) levels were significantly lower in patients with PCOS and a FH of T2DM. In patients with PCOS with a FH of T2DM in first-degree relatives, age and levels of FBG, FINS, and HOMA-IR were significantly higher than those who had a FH of T2DM in second-degree relatives. A maternal history of T2DM was associated with a higher body mass index, FAI, and TG levels, and lower SHBG levels. Conclusions Patients with PCOS and a FH of T2DM have more severe hyperandrogenism and metabolic disorders, especially in those with maternal transmission.

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The Cardiovascular Events in Metabolic Surgery Compared to the New Classes of Glucose-Lowering Agents in Patients with T2DM

Journal of Endocrinology and Metabolism Research ◽

10.37191/mapsci-2582-7960-2(2)-019 ◽

2021 ◽

Author(s):

Najla Shamsi

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

Metabolic Surgery ◽

Cardiovascular Events ◽

Controlled Trials ◽

Glucose Lowering ◽

Randomized Controlled ◽

History Of

Type 2 Diabetes Mellitus is a prevalent chronic disease with several macrovascular and microvascular complications. Cardiovascular diseases including coronary artery disease and stroke are common macrovascular complication that reduces the quality of life and lead to early mortality. Additionally, they pose enormous socioeconomic burden on the societies and the governments. Therefore, any intervention that reduces the cardiovascular events in patients with diabetes will have positive impact of the patients and the society. Thus, this systematic review aimed to evaluate the cardiovascular events after metabolic surgery in comparison with the new classes of glucose lowering agents in patients with type 2 diabetes mellitus. The review included 11 randomized controlled trials to both GLP-1 RA and SGLT-2 i groups. It also included 7 metabolic surgery studies, 2 of these are randomized controlled trials and the other 5 are observational studies. These studies were the most relevant studies to the research question. The results revealed different baseline demographic and clinical characteristics between the medication trials and metabolic surgery studies. Moreover, it revealed significant reduction in cardiovascular events in metabolic surgery studies when compared to medication trials. It also showed significant HbA1c and weight reduction in the metabolic surgery group. The remission of diabetes was very high in the metabolic surgery group while none of medication trials accomplished diabetes recovery. However, both medication and surgery groups had adverse events. In conclusion, the review is consistent with previous literature. It suggests that metabolic surgery is more effective than medical therapy in reducing cardiovascular events. Although this conclusion should be interpreted with caution due to the differences in baseline characteristics between studies. In general, the review recommends younger adult diabetic patients with obesity and history of established cardiovascular diseases to undergo metabolic surgery. Whereas, older patients with history of cardiovascular disease should be advised to take one of the medications that has been proved to reduce cardiovascular events. Future studies that compare metabolic surgery and the new classes of the glucose lowering agents is recommended to confirm the findings in this review.

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New clusters of type 2 diabetes mellitus and their outcomes: relation between pharmacological treatment and previous cardiovascular events

European Journal of Public Health ◽

10.1093/eurpub/ckab120.043 ◽

2021 ◽

Vol 31 (Supplement_2) ◽

Author(s):

Claudio Santos ◽

Sonia Brito-Costa ◽

Luis Margalho ◽

Pedro Monteiro

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

Pharmacological Treatment ◽

Cardiovascular Events ◽

Glycated Haemoglobin ◽

Research Unit ◽

Clinical Research Unit ◽

History Of

Abstract Background Type 2 Diabetes Mellitus (T2DM) is the most common form of diabetes in adults, with 90% to 95% of cases. This study aims to establish clusters and have knowledge about the relationship between previous cardiovascular events and pharmacological treatment for T2DM. Methods 191 participants (EG) with T2DM with the average of 70.3 years (SD = 8.3) and 36 with pre-diabetes (CG) with an average of 62 years (SD = 10.3) who participated in clinical trials at Clinical Research Unit in Cardiology of Coimbra Hospital and Universitary Centre without cognitive difficulties, were divided in 5 different clusters. These were established based on six different variables: body mass index (BMI), age of each individual, age at diagnosis of DMT2, glycated haemoglobin value (HbA1c), homeostatic model that estimates the function of β cells (HOMA2-B) and insulin resistance (HOMA2-IR). Results Cluster 1 presented pre-diabetic individuals (15.9%), while diabetic individuals were divided into clusters 2 (1.8%), 3 (17.6%), 4 (21.1%) and 5 (43.6%). Regarding the study of the prevalence of previous cardiovascular events, the majority of individuals present in the different clusters had history of acute myocardial infarction (AMI). As for the prevalence of pharmacological treatment for DMT2, it was found that metformin was the most used drug. It was observed a relationship between previous AMI and metformin administration in clusters 3 (P = 0.0027; P < 0.05) and 5 (P = 0.0059; P < 0.05). Conclusions It was possible to create different clusters in a sample of the Portuguese population and to observe the existence of dependency relationships between different previous cardiovascular events and pharmacological treatment.

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TYPE 2 DIABETES MELLITUS;

The Professional Medical Journal ◽

10.29309/tpmj/2013.20.02.678 ◽

2013 ◽

Vol 20 (02) ◽

pp. 237-243

Author(s):

GHULAM HUSSAIN BALOCH ◽

ABDUL QADIR DALL ◽

ATIF SITWAT HAYAT ◽

Syed Zulfiquar Ali Shah ◽

Bikha Ram Devrajani

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

University Hospital ◽

Diabetic Patients ◽

Haemoglobin A1c ◽

Type 2 Diabetic Patients ◽

History Of ◽

Upper Molar

Objective: To determine the frequency and pattern of dental carries in patients with type 2 diabetes mellitus. Design: Crosssectional descriptive study. Patients and methods: Patients with history of type 2 diabetes mellitus for ≥ 02 years duration with ≥ 35 years ofage and of either gender with dental pain visit at medical and dental outpatient department (OPD) of Liaquat University Hospital Hyderabad.The detail history was taken and the blood samples were taken for haemoglobin A1c (HbA1c) to assess the glycemic status. The existenceof dental carries and its pattern was diagnosed through dental examination by consultant dentist had clinical experience ≥05 years. The datawas collected on pre-designed proforma, entered and analyzed in SPSS version 11.00. Results: A total of 137 type 2 diabetic patients wereselected for this study, out of these 82 were males and 55 females. The dental carries was found in 98 (71.5%) patients. Out of these ninetyeight, 53 (54.08%) were males and 45 (45.92%) were female. Upper molar teeth involvement was present in 46 patients and lower molarteeth were involved in 52 patients. Dentine carries was seen in 35 patients, enamel carries in 19, white spot carries in 20 patients, pulpitis in16 patients, and pulp capping in 8 patients. Involvement of individual teeth was also assessed, the upper molar involvement was present in32 patients, premolar involvement was present in 11, incisor involvement in 03 patients. The lower molars were involved in 28 patients,lower pre molar in 21 and lower incisors in 03 patients. Dental carries was present in 43 (43.9%) patients in patients whose duration ofdiabetes was between 5-10 years, whereas those patients having duration >10 years had 31.6% frequency of dental carries, whileregarding duration of <5 years only 24 (24.5%) patients had dental carries. Conclusions: The diabetic patients are more prone to acquiredental caries.

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Assessing the Prevalence and Predicting Factors of an Abnormal Gated Myocardial Perfusion SPECT in Asymptomatic Patients with Type 2 Diabetes

10.21203/rs.3.rs-705161/v1 ◽

2021 ◽

Author(s):

Elinaz Hosseinzadeh ◽

Mohammadali Ghodsirad ◽

Toktam Alirezaei ◽

Maryam Arefnia ◽

Mahasti Amoui ◽

...

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

Male Gender ◽

Silent Myocardial Ischemia ◽

Duration Of Diabetes ◽

Predicting Factors ◽

Asymptomatic Patients ◽

History Of

Abstract IntroductionConsidering the significant prevalence of silent myocardial ischemia and its related morbidity and mortality in asymptomatic type two diabetic patients, it is not well known whether early screening with MPI is cost-effective. However, predicting factors are not elucidated. Materials and MethodsThis was a cross-sectional study including 63 asymptomatic patients with type 2 diabetes mellitus (T2DM), with normal ECG and ejection fraction. Patients with any history of documented valvular, congestive or ischemic heart disease, renal or hepatic failure were excluded. At first all patients were interviewed and checked for risk factors and then patients underwent a two-day rest/stress 99mTc-MIBI gated MPI SPECT. Data was assessed by QPS/QGS and 4DM software and evaluated by a nuclear medicine specialist with summed stress score (SSS) of more than 4 defined as CAD. ResultsThere were 42 females (67%) and 21 males (33%), with a mean age of 61.33 ± 6.98 years and 7.97 ± 4.86 years history of T2DM. CAD was detected in 26 (41.3%) patients and was significantly associated with male gender, smoking, requiring insulin therapy and EF (P-value = 0.019, 0.046, 0.05, 0.033, respectively). A significant association was found between the duration of diabetes, especially when >15y, and the probability of having CAD.. Multivariable logistic regression revealed that smoking; male gender and diabetes duration were the strongest independent predictors of abnormal MPI results.ConclusionWe found a high (46%) prevalence of abnormal stress MPI SPECT in patients with type 2 diabetes mellitus, despite being asymptomatic. Asymptomatic patients with a history of smoking, long duration of diabetes, being under insulin treatment and male gender might benefit from MPI for early detection of silent ischemia.

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Sociodemographic, anthropometric and physical fitness parameters in healthy individuals with and without family history of Hypertension and/ or Type 2 Diabetes Mellitus

Journal of Medical Science And clinical Research ◽

10.18535/jmscr/v5i8.02 ◽

2017 ◽

Vol 5 (8) ◽

Author(s):

Dr Shivani Agarwal ◽

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

Family History ◽

Physical Fitness ◽

Healthy Individuals ◽

Fitness Parameters ◽

History Of ◽

Family History Of Hypertension

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Significant polar vasculosis in a patient with a 30-year history of type 2 diabetes

Endocrinology Diabetes and Metabolism Case Reports ◽

10.1530/edm-19-0092 ◽

2019 ◽

Vol 2019 ◽

Author(s):

Yasuhiro Oda ◽

Masayuki Yamanouchi ◽

Hiroki Mizuno ◽

Rikako Hiramatsu ◽

Tatsuya Suwabe ◽

...

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

Endothelial Damage ◽

Diabetic Patients ◽

List Type ◽

History Of ◽

Intraglomerular Pressure ◽

Vascular Formation

Summary We report the renal histology of a 66-year-old man with hypertension, cardiovascular disease, and a 30-year history of type 2 diabetes mellitus with proliferative diabetic retinopathy, diabetic neuropathy, and diabetic foot status post toe amputation. Urinary protein excretion was 1.4 g/gCr, serum creatinine level 0.86 mg/dL, estimated glomerular filtration rate 69 mL/min/1.73 m2, and HbA1c 13–15%, despite using insulin. Light microscopy showed global glomerulosclerosis in 37% of the glomeruli, but the remaining glomeruli were intact. Significant polar vasculosis was present, while arteriolar sclerosis was mild. Electron microscopy revealed a thickened glomerular basement membrane, which is compatible with the early stage of diabetic glomerulopathy. The presented case was unique because glomerular changes seen typically in diabetes were not seen in the patient, despite the long-standing history of diabetes and diabetic comorbidities, while prominent polar vasculosis was found. Polar vascular formation helps preserve the glomeruli by allowing hyperosmotic blood bypass the glomeruli; this decreases intraglomerular pressure and minimizes glomerular endothelial damage. Learning points: A 66-year-old man with a 30-year history of type 2 diabetes mellitus with poor glycemic control underwent renal biopsy, which showed scarce glomerular changes typically seen in diabetic kidney disease and instead revealed significant polar vasculosis. Past studies demonstrated that the increased small vessels around the vascular hilus in diabetic patients originated from the afferent arterioles and drained into the peritubular capillaries. Polar vascular formation may preserve glomerular function by allowing the blood flow to bypass the glomeruli and decreasing the intraglomerular pressure, which minimizes endothelial damage of the glomerular tufts.

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